Induced demand: A challenge on the way of Iran Health Revolution Program

By comparing indefinite demand and definite resources during the time, induced demand leads to an increase in the share of people in health costs. This may turn into a critical challenge in health system if not managed appropriately. The aim of the current study is to explain the different dimensions of influential factors in induced demand. In addition, changes in induced demand from the beginning of its implementation in the health program are studies as well. This study was carried out through semi-structured interviews with the managers of health care system in Isfahan Province, Iran, which offer health service in three levels: first, second, and third. After the implementation of seven packages of Health Revolution Program, four fundamental concepts of influential fundamental and social factors in induced demand, the organizational structure, and interested parties were studied in 2015. Our findings show that the health Revolution Program has caused an increase in induced demand through social factors (incremental demand, physician-centered system), fundamental factors (lost influence of Referral and Family Physician Programs),the organizational structure(weakness in the educational system, ignoring medicine ethics, lack of regulatory programs), and interested parties (suppliers and receivers). Induced demand increases the affordable costs index. This, in turn, influences the positive acquired results of the program and decreases effective allocation of national resources. This can be managed using such strategies as improving managers' insight about supporting induced demand control, appropriate planning in health care system, correcting the educational system in the field of health care, correcting the payment and referral systems

Research barriers from the viewpoint of faculty members and students of Ardabil University of Medical Sciences, Iran, 2014

Background: Due to its role in identifying educational, research, health problems and providing a solution to prevail upon the problems related to public health, the research in the Medical Sciences University has a special importance. The present research aims to determine the restraining factors of doing research from the viewpoint of professors and students of the Medical Sciences University of Ardabil; it was conducted in 2014.Methods: In this descriptive cross-sectional study, 250 individuals from between the professors (50 individuals) and students (200 individuals) of the various academic disciplines of medical sciences were selected by way of completely random sampling. The data collection tool was a researcher-made questionnaire containing 3 parts: demographic information, individual barriers (10 questions) and organizational and environmental barriers (25 questions) based on the binary scale (Yes or No). By using the descriptive statistics and student t-test, data were analyzed with the significance level of 0.05, in the software SPSS19.Results: In the area of organizational factors, the most important restraining factor of the research activities of students was the lack of access to information sources (73.2%) and in the area of individual factors the main obstacle was lack of domination in English (68.6%). Also, the administrative restrictive regulations (73.3%) as the most important organizational restraining factor and lack of time due to job preoccupation (68.9%) as the main individual barrier were recognized for doing research in view of professors. There is not any statistical significant difference between the view of students under study in all the influential individual barriers other than the being unimportant of research from my view and having the negative attitude towards the research works in the view of professors. Also, there is a significant difference between students’ view in all effective organizational barriers other than lack of research in the chapter heading of courses of most of fields and the professors’ view. In total the score of organizational barriers was more than that of the individual barriers.Conclusions: Organizational barriers and personal barriers have an important role in doing the research in the Medical Sciences University of Ardabil; these barriers can be passed through. The availability of consulting forces and sufficient and necessary counseling, teaching know-how and attitude correction, compensating the lack of facilities and equipment, creating the motivation by the authorities and educating and empowering as executive working procedures are recommended for overcoming the research barriers in the universities

Proactive risk assessment of the laboratory management process inGhaem Hospital, Mashhad (2013)

Laboratory errors may occur in every stage of laboratory management process and lead to a considerable harm to inpatients. This study was aim to investigate the Proactive risk assessment of the laboratory management process in Ghaem Hospital, Mashhad (2013). This was a descriptive research that quantitatively and qualitatively analyzed some failure modes and effects. In order to classify the modes of failure and effective causes of them and also determining the improvement strategies, we have used "nursing error management association", "Eindhoven" and "theory of inventive problem solving" models respectively. In 5 steps of laboratory management process which is conducted on17 listed sub-processes, on average 59 error modes in each ward was identified. 18.7% of error modes were identified as high risk errors (hazard score ≥ 8). Most of error causes were related to human factors (42.7%).In addition, 31.6% of preventive measures were assigned in human resources management strategy group and 16.9% in team work group. The Healthcare Failure Mode and Effect Analysis method was very efficient in identifying failure modes, determining causes which impact each failure mode, and proposing improvement strategies for laboratory management processes of Ghaem Department.

Customers’ Complaints and its Determinants: The Case of a Training Educational Hospital in Iran

Background: Today, despite the efforts of the medical community and healthcare staff along with the advancements in medical technology, patients’ dissatisfaction and complaints have been increased. The present study aimed at making a survey on the patients’ complaints in a large training hospital affiliated to Mashhad University of Medical Sciences (MUMS). Methods: This descriptive, cross-sectional study was conducted on written and verbal complaints of patients and their relatives in a tertiary (specialty and sub-specialty) training hospital. All the recorded patients’ complaints, from March to December 2012, were reviewed. Data were categorized and analyzed using descriptive statistics by Microsoft Excel 2007. Results: A total of 233 complaints were reviewed, of which 46.35%, 31.34% and 22.31%, respectively, were verbal, written and made on the phone. The main reasons for complaints were accessibility to medical staff (21.46%), communication failures (20.17%) and dissatisfaction with the provided care (14.59%). Thirty one (13.31%) cases were solved at first place, 194 (83.26%) referred to the complaints from the committee and 3.43% referred to the legal authorities. The average response time was about six to seven days. Conclusion: The findings of the study suggest that sufficient availability of medical staff, improvement in communication skills and paying attention to the patients’ needs and expectations may reduce complaints from public health facilities

Spiritual health in cancer patients at OMID hospital affiliated with Mashhad University of Medical Sciences -2012

For downloading the full-text of this article please click here.Background and Objectives: Due to high prevalence of cancer and its destructive impact on spiritual health of patients, this study aim to investigate Spiritual health in cancer patients at OMID hospital affiliated with Mashhad University of Medical Sciences, 2012. Materials and Methods: In this descriptive cross-sectional study, the study population was 106 cancer patients referred to hospital. Paloutzian-Ellison questionnaire (1982) and convenience sampling were used to collect data which were analyzed using SPSS 16.Results: The mean scores of spiritual health, religious health and existential health were 97±1.2, 52.1±6.4 and 44.8±8.4 respectively .There was not statistical significant relationship between Spiritual health and  demographic factors. Conclusion: Spiritual health in cancer patients was intermediate. Promotion of spiritual health in diseases such as cancer that it is effective on the body, mind and spirit be taken into consideration specifically, because the Promotion of spiritual health leads to physical and mental health promotion. Keywords: Cancer, Spiritual health, HospitalFor downloading the full-text of this article please click here

Original Article Customers' Complaints and its Determinants: The Case of a Training Educational Hospital in Iran

Background: Today, despite the efforts of the medical community and healthcare staff along with the advancements in medical technology, patients' dissatisfaction and complaints have been increased. The present study aimed at making a survey on the patients' complaints in a large training hospital affiliated to Mashhad University of Medical Sciences (MUMS). Methods: This descriptive, cross-sectional study was conducted on written and verbal complaints of patients and their relatives in a tertiary (specialty and sub-specialty) training hospital. All the recorded patients' complaints, from March to December 2012, were reviewed. Data were categorized and analyzed using descriptive statistics by Microsoft Excel 2007. Results: A total of 233 complaints were reviewed, of which 46.35%, 31.34% and 22.31%, respectively, were verbal, written and made on the phone. The main reasons for complaints were accessibility to medical staff (21.46%), communication failures (20.17%) and dissatisfaction with the provided care (14.59%). Thirty one (13.31%) cases were solved at first place, 194 (83.26%) referred to the complaints from the committee and 3.43% referred to the legal authorities. The average response time was about six to seven days. Conclusion: The findings of the study suggest that sufficient availability of medical staff, improvement in communication skills and paying attention to the patients' needs and expectations may reduce complaints from public health facilities

The quality assessment of family physician service in rural regions, Northeast of Iran in 2012

Background: Following the implementation of family physician plan in rural areas, the quantity of provided services has been increased, but what leads on the next topic is the improvement in expected quality of service, as well. The present study aims at determining the gap between patients’ expectation and perception from the quality of services provided by family physicians during the spring and summer of 2012. Methods: This was a cross-sectional study in which 480 patients who referred to family physician centers were selected with clustering and simple randomized method. Data were collected through SERVQUAL standard questionnaire and were analyzed with descriptive statistics, using statistical T-test, Kruskal-Wallis, and Wilcoxon signed-rank tests by SPSS 16 at a significance level of 0.05. Results: The difference between the mean scores of expectation and perception was about -0.93, which is considered as statistically significant difference ( P ≤ 0.05). Also, the differences in five dimensions of quality were as follows: tangible -1.10, reliability -0.87, responsiveness -1.06, assurance -0.83, and empathy -0.82. Findings showed that there was a significant difference between expectation and perception in five concepts of the provided services ( P ≤ 0.05 ). Conclusion: There was a gap between the ideal situation and the current situation of family physician quality of services. Our suggestion is maintaining a strong focus on patients, creating a medical practice that would exceed patients’ expectations, providing high-quality healthcare services, and realizing the continuous improvement of all processes. In both tangible and responsive, the gap was greater than the other dimensions. It is recommended that more attention should be paid to the physical appearance of the health center environment and the availability of staff and employee

Risk Assessment of Surgical Procedures in a Referral Hospital

Background: Adverse Events (AEs) due to failure in healthcare procedures are common. These procedures are often evaluated independently. The objectives of this study are to investigate the nature of the failures in healthcare procedures of the surgical patients, assessing the frequency of these failures and preventability, and exploring their consequences, underlying causes, and prevention strategies in a referral hospital in the center of Iran. Materials and Methods: This study is a prospective quantitative and qualitative research. Focus Group Discussion (FGD) meetings have been conducted to understand potential failures, their consequences, causes, and prevention strategies. Afterwards, the frequencies of these concepts have been determined separately in predefined subcategories in each step of the process. Results: The first phase of the patient care process was the most risk-prone phase. Temporary or permanent disability at the time of discharge (final impacts), inflammation/infection (injuries), the rule-based behavior associated with coordination (causes), information and communication, preventability more than 50 were the most frequent failures and had achieved the highest score. Conclusion: Failures of healthcare processes are preventable to a high degree, although patients injure frequently. Interventions to mitigate these failures will enhance the reliability of surgical procedures

Customers’ Complaints and its Determinants: The Case of a Training Educational Hospital in Iran

Background: Today, despite the efforts of the medical community and healthcare staff along with the advancements in medical technology, patients’ dissatisfaction and complaints have been increased. The present study aimed at making a survey on the patients’ complaints in a large training hospital affiliated to Mashhad University of Medical Sciences (MUMS). Methods: This descriptive, cross-sectional study was conducted on written and verbal complaints of patients and their relatives in a tertiary (specialty and sub-specialty) training hospital. All the recorded patients’ complaints, from March to December 2012, were reviewed. Data were categorized and analyzed using descriptive statistics by Microsoft Excel 2007. Results: A total of 233 complaints were reviewed, of which 46.35%, 31.34% and 22.31%, respectively, were verbal, written and made on the phone. The main reasons for complaints were accessibility to medical staff (21.46%), communication failures (20.17%) and dissatisfaction with the provided care (14.59%). Thirty one (13.31%) cases were solved at first place, 194 (83.26%) referred to the complaints from the committee and 3.43% referred to the legal authorities. The average response time was about six to seven days. Conclusion: The findings of the study suggest that sufficient availability of medical staff, improvement in communication skills and paying attention to the patients’ needs and expectations may reduce complaints from public health facilities